To Unionize or Not To Unionize: Questions that every nurse should ask themselves

RN1989 · Apr 29, 2008

We have too many options and after all there is a shortage of us!

I'm sorry but there is not a shortage of nurses in the US. There is a shortage of nurses willing to work in unsafe and demeaning workplaces. Please learn more about the ratios of nurses holding licenses in the US that report they are working in nursing compared to large numbers of licensed nurses that report being unemployed or working outside of nursing. If there were a true nursing shortage, nurses could write their own employment tickets with no need for collective bargaining.

The employers along with associations such as the ANA, AHA, etc. work to divide nurses and perpetuate the shortage myth as an excuse to the public for crappy care. In reality, these organizations are well aware that there is not a real nursing shortage and use scare tactics to keep healthcare staff in line. As a manager, I heard first hand the comments that "nurses are a dime a dozen, if you don't like it here, leave and we'll have someone to replace you the same day". Employers aren't afraid. Why do you think they import ESL nurses into this country? Those nurses are afraid of deportation and being unable to send money home so they have no qualms about keeping their mouths shut and taking it without any surgilube.

New nurses should be scared. I've watched as it took nurses 20+ years before they go burned out and ready to quit. As time went on, it only took nurses about 15 years to decide to leave nursing. Things have progressed so far that now it only takes 1 year for many nurses to decide that they wasted their money on their nursing education. Obviously something is wrong.

There is definitely room for improvements with the unions and the possibility of corruption within them is always in the back of my mind. But I have also spent too many years seeing that nurses are afraid to stand up for what is right when they are the only ones doing it. So if unions give nurses courage to stand up for pts and themselves, then I say GO UNION!

jeolsz · Apr 29, 2008

I'm sorry but there is not a shortage of nurses in the US. There is a shortage of nurses willing to work in unsafe and demeaning workplaces. Please learn more about the ratios of nurses holding licenses in the US that report they are working in nursing compared to large numbers of licensed nurses that report being unemployed or working outside of nursing. If there were a true nursing shortage, nurses could write their own employment tickets with no need for collective bargaining.
New nurses should be scared. I've watched as it took nurses 20+ years before they go burned out and ready to quit. As time went on, it only took nurses about 15 years to decide to leave nursing. Things have progressed so far that now it only takes 1 year for many nurses to decide that they wasted their money on their nursing education. Obviously something is wrong.

WOW!.. I don't know where you live, but there is a shortage in the NY/NJ area. Listen, burn out happens whether you have a union or not. And you talk as if hospital nursing is their only option. There are so many different jobs you can have as an RN: Case Management, Ambulatory surgical centers, Schools, Corporate positions, Insurance Co's, Agency nursing, Hospice, Home care.. the list goes on.. New nurses, you have not wasted your money.. You have invested in one of the best career options out there! Bedside nursing is very difficult and ( this is only my opinion) meant for the young and strong ( I know I'm going to get skewered for that!) Pulling up 300 lbs of dead weight was not a job designed for a 50 year old woman ( or man.. I don't want to be sexest here!) Back to the point, however, you all still have not convinced me that a union has a place in professional nursing, considering some of the options I just listed.

Ludlow · Apr 30, 2008

Herring RN

WOW! Thanks for all that info!

It should be pointed out that the things Medicare wants to NOT reimburse for like hospital acquired decubiti are things that reduce with improved RN to patient ratios.

RN4MERCY · Apr 30, 2008

You all assume that management is with out intellegence or sensibility. Most managers have been staff nurses at one time and understand what is needed. We should be working together with management.. they are not the enemy! (quote)
Management has competing interests with workers. Management advocates for the business, bottom-line. Their raises depend on their "cost" savings. Nurse managers are often given budgets that aren't sufficient for them to hire enough nurses to provide meal and break relief, or enough nurses to staff up based on the patient's acuity. The greedy ones squeeze their staffs, or fail to hire more nurses because they get to keep a percentage of what they save. This is how they incentivize their bad behavior. Self interest!
RNs have a duty to advocate in the exclusive interests of their patients. According to Title 16, Standards of Competent Performance in California, The RN, "Acts as the client's advocate, as circumstances require by initiating action to improve health care or to change decisions or activities which are against the interests or wishes of the client."
Many managers that I've known run from the bedside as fast as they can; they dress in such a way as to dissuade a request for hands on help. For many it's been years since they've dealt with the business end of a bedpan. They may not be "the enemy" but they have to make choices between what's right and what's wrong. Pushing for early transfers and discharges, sending staff home early, or calling off staff when the remaining staff will not have break relief or the patients won't get the nursing care they need because of high acuity-dependency, complex treatments, comorbidities...are examples of self-interested, business advocacy. Not the same as staff nurse/patient advocacy.

jeolsz · Apr 30, 2008

Herring RN
WOW! Thanks for all that info!
It should be pointed out that the things Medicare wants to NOT reimburse for like hospital acquired decubiti are things that reduce with improved RN to patient ratios.

Yeah, great info, but where in all those statements does it say unions alone improve nurse-patient ratios? My experience with unions is that they mainly consentrate on salary and benefits, not so much working conditions such as staffing. And while it is true you can file grievences thru the union and they act as an advocate for you in such issues, you can also have much of the same without a union. Most hospitals have policies and procedures, with a manuel supplied to every floor. If a policy is not followed and an adverse event happens because of it, there is a procedure that is followed to rectify the situation. Now, of course this requires less whining and complaining to a 3rd party and more interaction on the part of the employee and manager.

Prevention of decubiti requires more than just turning q 2.. Today there are special beds that help.. Teamwork and prioritization also help to prevent bedsores. And while its true some days seem endless and stressful I still believe it is part of the job, and no union can fix all problems.

allnurses Guide · Apr 30, 2008

Yeah, great info, but where in all those statements does it say unions alone improve nurse-patient ratios? My experience with unions is that they mainly consentrate on salary and benefits, not so much working conditions such as staffing. And while it is true you can file grievences thru the union and they act as an advocate for you in such issues, you can also have much of the same without a union. Most hospitals have policies and procedures, with a manuel supplied to every floor. If a policy is not followed and an adverse event happens because of it, there is a procedure that is followed to rectify the situation. Now, of course this requires less whining and complaining to a 3rd party and more interaction on the part of the employee and manager.
Prevention of decubiti requires more than just turning q 2.. Today there are special beds that help.. Teamwork and prioritization also help to prevent bedsores. And while its true some days seem endless and stressful I still believe it is part of the job, and no union can fix all problems.

No one said a union can fix all problems. There will always be problems.

It is morre effective to work together to solve these problems.

In California the California Nurses Association/NNOC nurses worked for 12 years to get the ratio law passes and for the regulations into effect.

Four years later it is the union education nurses to enforce them

It was this same union nurses who prevented the governor from unilaterally

eliminated safe staffing law and regulation in med-surg and the ER.

Even before the implementation of the ratios a study showed MI survival is improved at hospitals with an RN union.

RN4MERCY · Apr 30, 2008

Yeah, great info, but where in all those statements does it say unions alone improve nurse-patient ratios? My experience with unions is that they mainly consentrate on salary and benefits, not so much working conditions such as staffing. And while it is true you can file grievences thru the union and they act as an advocate for you in such issues, you can also have much of the same without a union. Most hospitals have policies and procedures, with a manuel supplied to every floor. If a policy is not followed and an adverse event happens because of it, there is a procedure that is followed to rectify the situation. Now, of course this requires less whining and complaining to a 3rd party and more interaction on the part of the employee and manager.
Prevention of decubiti requires more than just turning q 2.. Today there are special beds that help.. Teamwork and prioritization also help to prevent bedsores. And while its true some days seem endless and stressful I still believe it is part of the job, and no union can fix all problems.

A union is only as strong as the solidarity of it's members. They must act collectively, and in unity on solutions to the working conditions that are barriers to safe and effective patient care.

Your experience, evidently doesn't include active membership and participation in a union as a nurse organizer, bargaining council member, nurse rep, or steward.

The California Nurses Association members worked to achieve passage of the first in the nation safe staffing law. It was a 12 year fight to establish minimum nurse to patient ratios. In addition, the law requires employers to "staff up" from the minimum, and additional staff must be included, based on the acuity of the patients, to meet their needs. The acuity of the patients is determined by the independent professional judgement of the direct care nurse. :yeah:

http://www.calnurses.org/nursing-practice/ratios/ratios_index.html

With regards to grievances, RNs have a responsibility to notify their supervisor of any condition that they believe is unsafe. Hospitals have policies and procedures, but in my experience there has been a distinct trend away from fair and legal treatment of employees. There may be a policy regarding leave of absence, or overtime, or staffing; employees are told, "you don't qualify" or "do the best you can" or "you're not a team player" and they often fear retaliation when they respectfully and thoughtfully seek redress for their issues. RNs who do so are often unfairly branded as whiners and complainers in an often times successful attempt to marginalize and ultimately silence them. Many excellent nurses leave the profession; thus, the industry contributes to the so-called nursing shortage. I don't believe that silencing protects nurses or their patients; those working conditions shouldn't be endured and worn as a "badge of honor" and accepted as "coming with the territory"!

Unfortunately, being a good nurse is not the same as being a good employee in many hospitals. Union members raise the bar, collectively for all workers, in terms of wages, hours, and working conditions. Unions have been responsible for worker comp laws, meal and break laws, equal pay for equal work laws, and freedom of association and rights for workers to form and belong to unions, and Weingarten rights, so you don't have to go into the manager's office or HR without representation and due process.

CNA/NNOC is not a third party union. It is a democratic member run labor and professional organization. A standard provision in our contracts is for the election of direct care nurses to an independent committee, called Professional Practice Committee. No management appointees. Nurses need a forum to speak freely and collectively work on solutions to present to management when staffing and acuity concerns are ignored at the unit level. We document our concerns, in writing, to eliminate administrative deniability. This becomes important if there is a poor patient outcome because it proves that management was notified that, in the judgement of the nurse, staffing was insufficient to meet the needs of the patient. Liability for staffing decisions that cause harm to patients rests with management; a nurse can "do their best" and still errors, or omissions occur because of poor working conditions. Our union documentation and "just cause discipline" provisions prevents administration from blaming the nurse for a system failure.

Regarding pressure ulcers, there are many contributing factors including age, diabetes, incontinence, immobility, mulitsystem organ failure, low albumin/poor nutrition, etc. If there aren't enough special beds to go around, or enough nurses and lift teams, or aides to turn the patients those are environment of care issues that will also predispose a patient to acquiring pressure ulcers or pose a barrier to healing them.

Many states now have ratio laws progressing through their legislatures, as the result of the collective action of NNOC members. Hospital associations and executive management groups are spending huge amounts of money to oppose them, like they did in California. They want to retain control of their ability to blame nurses for their failures to budget to meet the needs of patients; it's often all about their bottom line. If employers can circumvent their legal responsibilities and squeeze their nursing staffs to make a buck, many do so.

Without a union contract, and members willing to enforce the laws at the facility level, management can give, and management can take away, at will. Your job, your benefits, your will to continue to practice nursing, the way you were educated and are legally required to do.

jeolsz · May 1, 2008

Without a union contract, and members willing to enforce the laws at the facility level, management can give, and management can take away, at will. Your job, your benefits, your will to continue to practice nursing, the way you were educated and are legally required to do.

Never happened at the hospitals I worked at with out unions. In fact where my sister in law worked, there was a union there for years and when that hospital was bought up by another hospital group, she lost seniority and benefits. Explain that one. I don't think union give absolute protection against everything that MIGHT happen in your workplace.

Lightenup Chicken Little, the sky's not falling! Not every hopsital needs or wants a union, especially where there is good management. And that's my point when the question was asked at the beginning of this thread: To unionize or not to unionize... Not every facility or nurse has the need to. And if the one I was in ever did , having been thru a unionization process many years ago...I'd be out looking for a non union facility.

Ludlow · May 1, 2008

Many managers that I've known run from the bedside as fast as they can; they dress in such a way as to dissuade a request for hands on help. For many it's been years since they've dealt with the business end of a bedpan. They may not be "the enemy" but they have to make choices between what's right and what's wrong. Pushing for early transfers and discharges, sending staff home early, or calling off staff when the remaining staff will not have break relief or the patients won't get the nursing care they need because of high acuity-dependency, complex treatments, comorbidities...are examples of self-interested, business advocacy. Not the same as staff nurse/patient advocacy.

I always thought that nurses who got promoted (and I'm not really sure it's a promotion) to manager somehow had to have a lobotomy as part of their management orientation. They seem to totally forget what it takes to be a bedside nurse. A few managers that I've had tried at times to fight for patient care, but as has already been noted they are the agents of the corporation and have to do their bidding or lose their job.

sharona97, BSN, RN · May 2, 2008

My DH came home from his Union meeting this AM. Does Commercial Journeymen work, building Targets, Restrarants, etc. Same local, his friendship for his brotherhoods work as Architecual Journeyman. Never divided the two crafts before. Kind if like I work telemetry and you work Cardiac ICU, but same bennies, same respect. 2 thousand didn't show up. But want to know if a strike was voted and this round the architecual journeyman will have their local union insurance taken away to just single coverage rather than family coverage. But not the Commercial workers.

Of course they will vote down the insurance and will strike, and they didn't buy their cards, they went to school for 5 years to learn their craft. HM2Viking is right,with his factual opinion concerning the cars. It happerns and Unions stick together like glue to fight for what is right. Plus they took srtike pay away now...... Or put it on the table...

The contractors can stilll bill the same and will get lower payed workers so it seems. Is that fair to the folks that have 30 years in the industry? You are good at what you do and in an instance become invaluable to your employers?

Now the Local BA's and the rest of them who needed to be there, will surely be at the next meeting. My point, you need to work your worth in or out of unions, but in a Union organization numbers of members count, contractors want bids and monies. These craftsmen want to work. Brotherhoods keep the key to a win-win situation if everyone cares and shows solidarity. It's easier to have others negotiate for you, or some folks talk down unions. But the ones who are there in brotherhood and speaking LOUDLY at the negotistions are actually helping to save all the brothers bennies and contracts.

It takes work to hold integrity for your own good worth and work. :twocents:

Mr_Interested · May 30, 2008

I am a former Hospital HR Director and my wife is an RN. In the area in which we live, all the hospitals are owned by one system. Thus, no competion and all power is with the administration. And, believe me, they use it! I would like to gain information as to which unions are best for nurses to consider electing these days, as I would like to help them organize here. We live in Florida. Thanks for any help you may give and for being the wonderful caregivers you are. People don't fully appreciate the work nurses do!

mobilsurgrn · May 30, 2008

I am a former Hospital HR Director and my wife is an RN. In the area in which we live, all the hospitals are owned by one system. Thus, no competion and all power is with the administration. And, believe me, they use it! I would like to gain information as to which unions are best for nurses to consider electing these days, as I would like to help them organize here. We live in Florida. Thanks for any help you may give and for being the wonderful caregivers you are. People don't fully appreciate the work nurses do!

Wow, you are a former HR Director and want to help organize a union in a right to work state. Did your training as a Hospital HR Director include any information about labor law?

Florida has a number of great nursing unions like SEIU (service workers) and the UFCW (food workers). Based on the overwhelming number of clinician members both of these great unions fully understand the needs of nurses. There have been union elections by nurses in Florida. To date, about 3% of Florida nurses are union members while just over 4% of Florida nurses are members of a local bowling league...

Best of luck!